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Pakistan National Emergency Action Plan – 2014

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Pakistan National Emergency Action Plan – 2014 National Emergency Action Plan 2014 For Polio Eradication Government of Islamic Republic of Pakistan Endorsement of National Emergency Action Plan 2014 for Polio Eradication The National Emergency Action Plan for Polio Eradication has been endorsed by the National Task Force for Polio Eradication chaired by the Prime Minister of Pakistan and participating by Chief Ministers, Governor Khyber Pakhtunkhwa/FATA, Prime Minister AJK and heads of Partner Agencies in January 2014. Mian Muhammad Nawaz Sharif Prime Minister, Islamic Republic of Pakistan (Chairperson, National Task Force for Polio Eradication) 2 Foreword Pakistan’s polio eradication programme faced a number of significant challenges in 2013. These challenges meant that the ambition to stop the transmission of wild poliovirus by the end of the year was unfortunately not possible. In fact, the programme was severely challenged in 2013, as the number of wild polio cases increased on last year’s count. There are multiple reasons for why this was the case. Unprecedented violent attacks on health workers, ongoing military operations in the tribal belt and a ban on polio drops called by militants in North Waziristan and South Waziristan created distinct barriers between vaccinators and children. Lapses in campaign quality and demand creation efforts are also partly to blame for the increase in the number of paralyzed children. However, despite these setbacks the programme also made progress. The number of districts infected with polio decreased, indicating that spread is more localized and type-3 of the poliovirus has not been detected for more than a year now. In 2014, we will endeavor to build on that progress. The polio eradication initiative is now paid for by the Government of Pakistan for the people of Pakistan. Polio will be eradicated by Pakistan and for the sake of Pakistan. The goal of NEAP 2014, to interrupt transmission of wild poliovirus in Pakistan by December, can only be achieved if all the strategies outlined in this document are rigorously implemented with special focus on the low transmission season in the first half of the year. Meaningful oversight and accountability at the UC level is one of the major areas that the programme needs to improve to have a real impact. The country is at a critical juncture and intensified polio eradication activities in the next few months will determine if eradication of poliovirus will be successful in 2014. The programme relies on strong provincial administrative and political leadership, as well as the district and agency administrations. Effective supervision and monitoring by Union Council Polio Eradication Committees and strong motivation of frontline workers will be instrumental in achieving polio eradication. We must all face the challenges ahead and work together for the sake of our children to make Pakistan polio free. Ayesha Raza Farooq Prime Minister’s Focal Person for Polio Eradication 3 Contents Acronyms and abbreviations................................................................................... 6 Executive Summary ..................................................... Error! Bookmark not defined. Context and Challenges ........................................................................................ 10 i. Progress in 2013 and development of the NEAP 2014 ............................................................. 10 ii. Current Epidemiology ............................................................................................................... 11 iii. Challenges for 2014 .................................................................................................................. 13 Lessons Learnt in 2013 .......................................................................................... 15 The National Emergency Action Plan 2014 ............................................................ 16 i. GOAL ......................................................................................................................................... 16 ii. OBJECTIVES ............................................................................................................................... 16 iii. Guiding principles for 2014....................................................................................................... 16 iv. MILESTONES ............................................................................................................................. 16 OVERSIGHT AND MANAGEMENT OF THE PROGRAMME ................................................................. 17 1. National management and oversight of the NEAP .................................................................. 17 2. Oversight mechanism in provinces for NEAP implementation ................................................ 18 3. Oversight and accountability at the district level .................................................................... 19 4. District and Sub-District level committees to oversee campaign operations (preparation and implementation) ........................................................................................................................... 20 5. Deferment of scheduled campaigns in case of inadequate preparations ............................... 23 6. Prioritization of Districts and Areas for conducting polio SIAs ................................................. 23 7. Communication Strategies ....................................................................................................... 26 8. Functional Vaccine Management Committees at All Levels .................................................... 27 9. Functioning Security System .................................................................................................... 28 10. Emergency Rapid Response-Team .......................................................................................... 28 Key strategies for 2014 with special focus on reservoirs ........................................ 29 1. All missed Children to be tracked and vaccinated after each campaign ..................................... 29 2. Short Interval Additional Dose strategy (SIADs) .......................................................................... 30 3. Special Strategies targeting underserved, migrant and transit populations ............................... 30 4 4. Social mobilizers to support missed children strategy ................................................................ 31 5. Surveillance strategy ..................................................................................................................... 32 6. Integrated control rooms ............................................................................................................. 32 7. Strengthening Monitoring and Evaluation mechanisms .............................................................. 33 8. Special Focus on High Risk Polio UCs ........................................................................................... 34 9. Strengthening partnerships for FATA .......................................................................................... 35 10. Direct Disbursement Mechanism (DDM) ................................................................................... 37 11. Integrated micro-planning at Union Council Level ..................................................................... 37 12. Strengthening Intra-provincial and cross-border coordination .................................................. 38 14. Improving overall vaccine management during SIAs .................................................................. 39 15. Optimizing the Polio Eradication Initiative for strengthening Routine Immunization ............... 40 16. Training and Capacity Building .................................................................................................... 41 17. Vaccine Procurement .................................................................................................................. 41 Conclusion ............................................................................................................ 42 Annex I Terms of Reference of the National Steering Committee and subcommittees: a) Weekly Surveillance Meeting b) Vaccine Management Committee c) NCTC and PCTC Annex II: DPEC functions and composition Annex III: TPEC functions and composition Annex IV: UPEC functions and composition Annex V: SOPs for polio control/operations rooms Annex VI: Schedule of SIAs in 2014 and prioritization of districts Annex VII: Performance indicators for preparation, implementation and assessment Annex VIII: Emergency operational, communication and security guidelines Annex IX: SOP for transit strategy Annex X: SOPs for addressing clusters of still missed children including refusals Annex XI: Surveillance for poliovirus Annex XII : PEI Support for Routine Immunization and Monitoring checklist Annex XIII : DDM Process and Rights of Polio Workers Annex XIV : Transit strategy for polio eradication in Pakistan 5 Acronyms and abbreviations AFP Acute Flaccid Paralysis AJK Azad Jammu & Kashmir APEC Agency Polio Eradication Committee CM Chief Minister CNIC Computerized National Identity Card DC Deputy Commissioner DCO District Coordination Officer DHCSO District Health Communication Support Officer DPEC District Polio Eradication Committee DDHO Deputy District Heath Officer DDM Direct Disbursement Mechanism EDO Executive District Officer EPI Expanded Programme on Immunization FATA FATA Federally Administered
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